Barbara Bardach: I know, I need to loosen up, I'm overprotective.I saw 'Finding Nemo', I get it. I don't need another story

Foreman: You're not just being overprotective. You're one of the most overprotective parents I've ever seen.

Barbara Bardach: She has the best private tutors. I let her friends visit. I'm not going to apologize... she almost died three times during her childhood - penicillin, bee stings, peanuts... six months ago, we leave her home alone for the first time on a weekend. She goes out, buys one chocolate chip cookie. Peanut butter in the dough. She's forgotten her EpiPen. She drives to the hospital, passes out, has an accident. Steering wheel crushed her chest. She ended up losing her heart. So when you say to me that I'm one of the most overprotective parents you've seen, please, please introduce me to the ones who were more overprotective, so that I can find out what they're doing right.

— Safe

Safe is a 2nd season episode of House which first aired on April 4, 2006. Melinda, an immunocompromised heart transplant recipient, goes into anaphylactic shock in her home clean room. The team has to deal with her increasingly severe symptoms and her wish to rebel against her mother's overprotectiveness. Meanwhile, the relationship between House and Wilson becomes increasingly strained as Wilson continues to live with House after separating from his wife.

The episode is mostly an interaction between the medical mystery, where House interacts with his team, and the main sub-plot - Wilson's recent separation from his third wife. In the beginning, House's involvement in the case is solely because Wilson is living with him, and, in the end, House can't solve the case without Wilson's help.

Although almost every episode explores the relationship between House and Wilson, in this episode, the relationship is put under the magnifying glass when Wilson has to spend all his off hours with House as well as working next to him at the hospital. In most cases, it would be the host in this relationship who would find stress in the situation, but House is flying through what would otherwise be an inconvenience. Instead, it's the guest who gets stressed out, having to put up with House's deliberate antics that seem destined to drive him away.

However, as Wilson later says out loud in The Social Contract, House may be a good friend, but he's not the type of guy to let you cry on his shoulder and tell you everything is going to be okay. In this case, Wilson is under the delusion that everything will be back to normal once he gets his own place to live. It's House who has to snap him back to reality - that Wilson's third marriage is over too, but everything is going to be all right despite that.

House's mechanism for doing this is trying to start a prank war. In ordinary circumstances, these two ultracompetitive Type A personalities would go out of their way to outdo each other. Had House not been crippled, they would have been doing it on the golf course or the jogging track. However, given the options, House all but dares Wilson to prank him by assuring him that he will feel better once he does. Eventually, Wilson takes the advice and proves House right.

By comparison, the medical mystery trots out some tropes that get explored in the series time after time, particularly the tensions between teenagers and their parents. In addition, Jennifer Morrison and Omar Epps also get to stretch their acting skills as Cameron and Foreman start to assert themselves.

During a visit from her boyfriend, an immunocompromised girl goes into anaphylactic shock despite the precautions they have taken to turn her bedroom into a clean room. Her mother manages to treat her with an EpiPen.

Wilson comes to tell House about the case. They get into an argument about who was supposed to wash the dishes. House is intrigued when he finds out the girl suffered from an allergic reaction despite being immunocompromised and in a cleanroom.

Cuddy briefs the team. They have tested the patient and her environment for four days without finding anything. House thinks someone is lying and asks his team to redo the environmental scan. Meanwhile, the patient is angry that her parents won't let her out of her bedroom. She wants to go back to school.

The mother and Foreman get into a confrontation about how protective the mother is. The mother says that she is overprotective because her daughter has had three life-threatening illnesses, including a recent heart transplant - the result of an auto accident after suffering an allergic reaction.

Chase and Cameron review the patient's bedroom and realize that the boyfriend could have snuck in the window. They confront the boyfriend, who admits to sneaking in and having sex with the patient. They obtain a semen sample, but tests show the patient is not allergic to her boyfriend's semen. House wants to check if he brought any other allergens in at the same time. House confronts the boyfriend, and he admits to taking unprescribed antibiotics, and House points out that his semen can pass on penicillin, which the patient is allergic to.

They decide that a reaction to penicillin would explain all her symptoms, and they choose to release her. Just as they are about to, she has a heart attack due to congestive heart failure.

The team can't think of any condition that would cause both anaphylactic shock and heart failure. They decide to concentrate on heart failure.

During the patient's MRI, Foreman and Cameron discuss teenagers having sex. The MRI shows no problems. The patient gets into a discussion with Foreman about how long she may live with her transplanted heart. Although Foreman is optimistic, the patient knows she is unlikely to make it more than ten years.

They perform a heart biopsy to determine if her heart is suffering from transplant rejection. Meanwhile, House has hung a stethoscope on his doorknob to inform Wilson that he is in there with a woman. Wilson has to wait outside of House's home for several hours. When House finally comes out, Wilson learns that House just wanted privacy to work on the case. They get into another argument.

The biopsy shows negative for rejection, and the blood tests don't show an infection. While Foreman discusses the situation with the parents, they discover the patient has run away. Foreman figures out she is heading for the roof to be outside and finds her in a stairwell. The patient starts talking about her problems with her overprotective mom. Foreman notices that her left leg appears to be partly paralyzed, and it is ascending quickly.

The new symptom doesn't add up either. The only possible disease that causes all three symptoms is tick paralysis, but there is no sign of a tick. They decide to concentrate on the paralysis. However, none of the tests are positive and the paralysis is getting worse. The best explanation they can come up with is Guillain-Barré syndrome, so they start treating her for it in the hope she will improve.

Wilson confronts House about erasing Wilson's phone messages about a possible new apartment. House admits to it and tells Wilson if he wants to confront him about not doing chores, he should be more proactive. House accuses Wilson of avoiding the fact he has to divorce his wife because if Wilson finds his own apartment, he will have to admit his marriage is over.

Meanwhile, the patient is getting worse, and her mother feels that she had resigned herself to death. Her usual personality is combative. The patient has another attack, this time because the paralysis has reached her lungs.

The patient is put on a respirator. The speed of the paralysis rules out Guillain-Barre, which moves far more slowly. The patient's parents lose confidence in House and turn to Cuddy to supervise the treatment. The team once again tries to determine a possible diagnosis. They decide on botulism as a possibility despite the fact the paralysis is going the wrong way (paralysis from botulism doesn't ascend, it descends). House finds Cuddy and Wilson examining the patient before an MRI. House examines the patient, but the only revelation is that the boyfriend wasn't using penicillin but another antibiotic, which rules out an allergic reaction. However, the boyfriend did walk through high grass, so House starts looking for a hidden tick. He is unable to find one before the patient goes into shock again. With the parents irate, Cuddy tosses House out of the room and calls for a cardiologist. Wilson suggests that she be taken to intensive care.

House is convinced there is a tick, and if they don't find it quickly, she will die, as the tick will keep pumping toxins into her body until they remove it. Cuddy overrules House and decides on a course of drugs and intensive care. They get ready to move the patient to the Intensive Care Unit on Wilson's recommendation; a ploy by Wilson to get House and the girl alone in the elevator.

House and Foreman intercept the patient in the elevator, and House pushes the emergency stop button and starts looking for the tick again. The patient is still in distress as House and Foreman argue about House's actions. Foreman finally decides to let House look and gives him three minutes. The patient's heart rate starts dropping while House and Foreman frantically look for the tick. Despite a thorough search, the patient's heart rate becomes critically low. Finally, House asks the patient if it was the first time she had sex, but she's unresponsive. He surmises that she wouldn't be used to the sensations in her groin and decides to examine her vagina. The elevator doors open as the father sees House looking at the daughter's pelvis underneath a modesty screen. As the father goes to attack House, House triumphantly comes up with the tick.

House is pleased with himself and thanks Wilson for suggesting that they move the patient, which allowed House to isolate the patient in the elevator.

Wilson denies that this was his intention.

At that moment, House's cane breaks, and he sprawls on the floor, looking around him, shocked.

Wilson notes in passing that it looks like someone cut partway through the rod and as he walks off, House smiles before he leans over and picks up his now broken cane.

After the patient recovers, her parents agree to let her out of her clean room and go back to school.

House goes home to Wilson, who has finally called a divorce lawyer.

Due to House having put Wilson's hand in warm water while he slept, it seems as though Wilson did pee himself on the couch where he was asleep.

Tick paralysis is not uncommon. There are dozens of cases a year, and the disease can appear anywhere ticks are found, particularly in warmer months. Suburban New Jersey is a great habitat for ticks. Some tick species will wander on a human body in search of the best spot to attach itself, and can be transfered between people during this time. Therefore it is also believable that the tick was transferred from the boyfriend to the patient during bodily contact. House was also right that the tick can attach to any part of the body.

• Barbara makes a reference to the movie Finding Nemo, by Disney Pixar Studios, pointing out her overprotective behavior, a trait that defines the protagonist of the said movie.
• Apparently, guest star Michelle Trachtenberg developed a crush on Hugh Laurie during filming. At the time of the climactic scene where House looks at the patient's pelvis, Trachtenberg had put a note saying "I Love You" under the modesty sheet.
• Cameron makes references to Tarzan a character first developed by Edgar Rice Burroughs in 1912. Cheetah was Tarzan's chimpanzee, the Elephant Graveyard was a mythical cache of ivory from dead elephants, and Jane was the young woman from civilization he fell in love with.
• It's a common misconception that putting a sleeping person's hand in warm water will make them urinate. The MythBusters experimented and found it either had no effect or woke the sleeping person.
• The movie that House and Wilson are watching at the end of the episode is Vertigo, a 1958 film directed by Alfred Hitchcock starring Jimmy Stewart and Kim Novak. Wilson also keeps a poster for this film in his office.
• It is shown that the address of House's home is 221 apartment B, which is close to Sherlock Holmes and Dr. Watson's home address of 221B Baker Street.
• The beer in House's refrigerator has a flip-top, a top that probably indicates it is the only brand that uses such a top - Grolsch.
• William Tell is a mythical Swiss hero who shot an apple on his son's head with a crossbow to gain his freedom. He is also referenced in Out of the Chute.
• "The boy in the plastic bubble" is based on the story of David Vetter, who lived in a sterile environment due to his severe combined immunodeficiency. A highly fictionalized version of his story was made in 1976 and starred John Travolta. Vetter's case also inspired the famous Seinfeld episode The Bubble Boy.
• Agatha Christie was one of the most prolific and successful authors of all time. She achieved her greatest successes with murder mysteries and created the character Hercule Poirot. She also authored the longest-running stage play of all time, The Mousetrap, which has been in a continuous run in London since 1952.
• Brillo Pads are a brand of steel wool pads impregnated with soap.
• Hanging something over a doorknob is a common way for roommates to signal that they need privacy (usually for sexual relations) in an obvious but unobtrusive manner. It is very common in college dormitories.
• The New Jersey Journal of Cardiology is fictitious.
• At two points in the episode, Foreman tries to tell someone how he got his mother to be less overprotective when he was a sick eight year old but got cut off both times. We never do learn what happened.
• House mentions that Steve McQueen is still alive when Cameron suggests using him as a lab rat.
• "Short sheeting" is a prank where the top sheet is folded in half with both ends at the top of the bed and the fold in the middle. It looks normal under a blanket or comforter, but when you attempt to get in, your legs only go down to the fold.

Treatment of minors and parental consent:

The law and codes of medical ethics are clear - for a minor (anyone under the age of 18), the parents have a complete say over medical treatment choices. This extends to respecting the parents' wishes about informing their child about the nature of the treatment and their prognosis. In other words, if the parents want to lie to their child about how ill they are and the risks of treatment, that's entirely up to them.

However, these ethical protocols are often difficult to apply once a minor reaches the age of reason (about the age of seven) and often becomes impossible in a very old minor who can usually figure out things on their own. Indeed, with an older child, if the parents want to pursue a non-traditional treatment for philosophical reasons (anything from refusing a blood transfusion to refusing a vaccination), the ability of the child to understand the consequences of that choice, and agree with the decision, often forestalls the appointment of a guardian ad litem for the child.

In this case, although Melinda's parents make sound choices about her treatment for her acute medical condition, their decisions about her chronic medical condition are more borderline, particularly when looking at Melinda's wishes, which would also be acceptable choices for an adult in the same situation. However, Barbara is within her rights to admonish Foreman for telling Melinda there is no further need for her to be kept in a sterile environment. Technically, that is Barbara's choice. Also, Barbara is within her rights to stop Foreman from discussing the matter with her and trying to change her mind.

The series also explores this issue in many other episodes, including Autopsy, Skin Deep, Poison, Paternity, and Detox.

Non-protocol treatment:

Although diagnoses are important, it is also important to ensure that a patient is stable before embarking on any course of testing or treatment. When a patient is not stable, it is critical to get their blood pressure and heart rate under control. This is why trauma patients who need surgery are still taken to the emergency room first - the emergency room has the equipment to get the patient's vital signs under control - the operating room does not.

As such, House's choice to continue the "magic tick hunt" was probably ill-considered. He could have continued to press Cuddy about it once Melinda's heart distress had been brought under control. Even House said it would take at least an hour for her to die, and with intensive care, she could have been kept on life support for much longer.

As Dr. Schaffer pointed out when she fired Eric Foreman in 97 Seconds, there is a reason why doctors have to follow protocol instead of going after hunches. Even House admits he's "almost always eventually right" and, although he succeeded this time, there was no guarantee that he was right. Had he been wrong, the consequences for Melinda could have been serious.

• Foreman gets a simple fact about centrifuging a blood sample wrong. When blood is centrifuged, the red blood cells, being the densest part of blood, fall to the bottom of the sample. The plasma rises to the top. In the middle is the small number of white blood cells and the platelets, which are about the same density. He states to the parents that the white blood cells go to the bottom, followed by the red cells, platelets, and plasma.
• In the scene where Chase tries to intubate Melinda, you see gloves on both hands at the beginning of the scene, but a glove only on his right hand as he performs the procedure. However, in the next shot, he has gloves on both hands again.
• The "tick" clearly has six legs in its close up. However, ticks are arachnids, related to spiders, and have eight legs.
• You usually have to wait forty-eight hours to pronounce a blood culture negative.
• The lungs, not being muscles, can't be paralyzed. Cameron and Foreman both probably mean the paralysis has spread to the diaphragm and chest muscles, which control breathing.
• Three problems with the anaphylaxis. First, anaphylaxis from tick paralysis usually sets in within four hours of a tick attaching, not the next morning. Second, there is usually a long period of warning symptoms, including labored breathing, before full-blown anaphylaxis kicks in and renders a person unable to speak. Lastly, if the tick set off the anaphylaxis, it should have continued as long as the tick was attached, meaning she would have needed constant intensive care to deal with the ongoing allergic reaction.
• Atropine is generally not used in cases of heart failure, and is ineffective in raising heart rate for heart transplant patients due to the Vagus nerve being severed.
• When assessing the heart, an echocardiogram, not a CT scan, is the best way to go.
• The paralysis spreads way too fast for tick paralysis. In a real case, once paralysis starts, it takes days, not hours, before it would spread above the waist.
• While Wilson is waiting outside of House's apartment, the door is clearly ajar long before evening sets in and is still ajar just before House opens the door.
• After House engages the elevator's emergency stop, the hall lanterns outside the ICU are shown flashing. Though obviously added with VFX, the lanterns aren't flashing in the very next shot even though Cuddy is clearly staring at them before she calls for the nursing staff to get Maintenance
• The cane would have broken after House had been putting his weight on it a while if Wilson had sawed partway through it. However, a cane in such a weakened state would also have broken during the altercation between House and Foreman when he was using the cane to pin Foreman against the wall, and Foreman was pressing against the cane with both hands to free himself.
• How could the patient climb up the stairs so quickly if she had any weakness in one of foot/leg? The scene had Foreman climb up multiple stairs. The patient would have at least mentioned the onset of some unusual weakness.